Cecilia S. Cannon, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

289 Issued in SC

Practice address

1762 E Main St
Spartanburg, SC 29307-2231

Phone

(864) 591-2261

Fax

(864) 591-2271

NPI assigned

Jan 24, 2007

Last updated

Jun 16, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Physician Partners of South Carolina PLLC

  • Emergency Medicine Physician
  • Spartanburg, SC
  • NPI 1003058876
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1275688772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HENDERSON ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012619",
            "telephone_number": "803-758-2602",
            "fax_number": "803-253-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 E MAIN ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293072231",
            "telephone_number": "864-591-2261",
            "fax_number": "864-591-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "CECILIA",
        "middle_name": "S.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia S Campbell, NP-C
• Rebecca K Campbell, PHARM.D.
• Suzzanne Mabel Candelaria Perez, DC
• Lidia Cannalunga, PT, DPT
• Addy Antley Cannon, PA-C
• Hayley Cannon, LMSW
• Matthew David Cannon, D.O.
• Ralph Donald Cannon Jr., RPH
• Stephanie Cannon, FNP-C
• James Richard Cantrell, PHARMD

• Physician Assistant in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.